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Combinations containing amoxicillin-clavulanate and tetracycline are inappropriate for Helicobacter pylori eradication despite high in vitro susceptibility

Cited 5 time in Web of Science Cited 6 time in Scopus
Authors
Cheon, Jae Hee; Kim, Sang Gyun; Kim, Jung Mogg; Kim, Nayoung; Lee, Dong Ho; Kim, Joo Sung; Jung, Hyun Chae; Song, In Sung
Issue Date
2006-08-25
Publisher
Wiley-Blackwell
Citation
J Gastroenterol Hepatol. 2006 Oct;21(10):1590-5.
Keywords
2-Pyridinylmethylsulfinylbenzimidazoles/therapeutic useAmoxicillin-Potassium Clavulanate Combination/*contraindicationsAnti-Bacterial Agents/*contraindicationsAnti-Ulcer Agents/therapeutic useBiopsyBismuth/therapeutic useDrug Therapy, CombinationEndoscopy, GastrointestinalFemaleHelicobacter Infections/*drug therapy/microbiology/pathologyHelicobacter pylori/drug effects/*isolation & purificationHumansMaleMetronidazole/therapeutic useMiddle AgedOrganometallic Compounds/therapeutic usePyloric Antrum/*microbiology/pathologyStomach Ulcer/drug therapy/microbiology/pathologyTetracycline/*contraindicationsTreatment Failure
Abstract
BACKGROUND: The purpose of the present paper was to evaluate the efficacy and tolerability of amoxicillin-clavulanate and tetracycline-based quadruple therapy as an alternative second-line treatment for H. pylori infection. METHODS: The study subjects consisted of 54 patients infected with H. pylori, in whom initial triple therapy had failed. Subjects were randomized to receive the following 7-day therapies: (i) pantoprazole 40 mg b.i.d., tripotassium dicitrate bismuthate 300 mg q.i.d., amoxicillin-clavulanate 1000 mg b.i.d., and tetracycline 500 mg q.i.d. (PBAT); or (ii) pantoprazole 40 mg b.i.d., tripotassium dicitrate bismuthate 300 mg q.i.d., metronidazole 500 mg t.i.d., and tetracycline 500 mg q.i.d. (PBMT). Eradication rates based on antibiotic susceptibility, drug compliance and side-effect rates were evaluated and compared. RESULTS: The H. pylori eradication rates were 16.0%/17.4% with PBAT and 65.5%/70.4% with PBMT by intention-to-treat (P<0.001) and per-protocol analyses (P<0.001), respectively. In patients who received PBAT, the eradication rates were only 16.7% (2/12) for both amoxicillin and tetracycline-susceptible H. pylori strains. Drug compliance and side-effect rates were similar in the two groups. CONCLUSIONS: Despite high individual in vitro antimicrobial activity, amoxicillin-clavulanate and tetracycline-based quadruple therapy showed low eradication rates, which strongly suggests that it should not be considered as a therapeutic option for H. pylori eradication.
ISSN
0815-9319 (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16928222

https://hdl.handle.net/10371/27525
DOI
https://doi.org/10.1111/j.1440-1746.2006.04291.x
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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